According to recent polling, nine percent of seniors over the age of 65 are currently taking Ozempic or other semaglutide medications to treat type 2 diabetes or for weight loss. (While some of these medications are approved for weight management, weight loss is sometimes achieved when the drugs are prescribed off-label.) Many doctors are optimistic about the far-reaching effects that these meds appear to have on various chronic illnesses, but they also acknowledge that older adults may also be more vulnerable to side effects.
“While the benefits of GLP-1 agonist drugs like Ozempic and Wegovy are well-documented, it's crucial to keep in mind that clinical trials do not include a robust number of older adults. This lack of data makes it difficult to fully understand how these medications affect people over 65, especially those using them long-term,” says HaVy Ngo-Hamilton, PharmD, a pharmacist and clinical consultant at BuzzRx.
She adds that it's important to be aware of the potential risks and to exercise caution when considering these medications for older adults. “While these are all specific to the individual patient and their unique health situation, I would caution older adults to consider the health risks before obtaining a prescription for semaglutide,” the pharmacist tells Best Life.
Wondering if Ozempic is right for you? Read on to learn the nine reasons you might avoid Ozempic if you’re over the age of 65.
RELATED: 7 Reasons You Should Consider Ozempic If You're Over 65.
1. Reduced muscle mass
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As we age, our muscle mass typically begins to decline. In fact, Tufts University researchers estimate that between the ages of 60 and 70, the average adult loses about 12 percent of muscle mass and can ultimately lose up to 30 percent by the age of 80.
Rapid weight loss can expedite this process in seniors, especially if strength training isn't a part of your daily regimen.
“Because older adults are already experiencing a gradual decrease in muscle mass, significant weight loss may put older adults at a higher risk of injuries as a result of falls leading to health complications, disability, and mobility issues,” says Ngo-Hamilton.
2. Reduced bone density
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People over the age of 65 may also experience a loss of bone mass, resulting in a heightened risk of injury. Sudden weight loss while using semaglutide injections can worsen your bone health by further reducing bone density.
“Significant weight loss, especially over a short time, can also contribute to a decrease in bone density, which may put older adults at increased risk of bone fractures or exacerbate pre-existing conditions such as osteoporosis,” says Ngo-Hamilton. She adds that porous bones are prone to fracture and can require extensive recovery.
The AARP estimates that for each pound of weight you lose, 25 percent will be from lost bone or muscle mass.
3. Dehydration
ShutterstockDehydration can cause dizziness and low blood pressure, making falls and injuries more likely. This is a serious consideration for seniors who are considering taking Ozempic, Ngo-Hamilton says.
“Older adults are more susceptible to dehydration due to reduced thirst response and lower total body fluid due to changes in the blood levels of electrolytes. All of these changes happen naturally as we age,” the pharmacist tells Best Life. “However, it's crucial to consider this risk because semaglutide (Ozempic, Wegovy) is notorious for its gastrointestinal (GI) side effects, such as nausea, vomiting, and diarrhea. As a result, elderly individuals are at higher risk for worsening dehydration.”
RELATED: Ozempic Is Not the Most Effective Drug for Weight Loss, New Study Says.
4. Skin aging
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Aesthetic concerns may not be reason enough to forgo a medication that can otherwise enhance your health. However, Joel Kopelman, MD, FACS, a top-rated facial plastic surgeon at Kopelman Aesthetic Surgery, says they’re still worth considering before taking Ozempic and similar medications—especially if you’re over 65.
“In my experience, while weight loss can be beneficial, especially in managing obesity-related conditions, excessive or rapid weight loss in those over 65 can lead to significant cosmetic concerns,” Kopelman tells Best Life.
He continues, “As we age, our skin naturally loses elasticity, and rapid weight loss can make this more pronounced, resulting in skin laxity, increased wrinkles, and a more gaunt appearance. For my patients who are concerned about maintaining a youthful look, this is something I carefully consider before recommending Ozempic.”
5. Orthostatic hypotension
iStockExperts also warn that orthostatic hypotension, a condition in which blood pressure drops significantly with position changes, is a potential risk for elderly adults taking Ozempic.
“This risk is particularly heightened by significant and rapid weight loss, especially if the individual is already dehydrated due to Ozempic's side effects, such as nausea, vomiting, and diarrhea,” says Ngo-Hamilton. “The condition can cause dizziness, lightheadedness, and a feeling of fainting, making it another risk factor for falls and injury in this population.”
6. Unintended ongoing weight loss
prapass / ShutterstockAccording to AARP, some older adults may find that their weight loss is hard to slow or stop once they’ve reached their optimal weight.
“A 16-year study followed people 45 to 76 years old who lost 6 percent of their body weight with diet and exercise. As the years went on, many participants started losing weight unintentionally,” the organization writes.
RELATED: Ozempic Patients Are Switching to These Less Expensive Weight-Loss Drugs.
7. Increased risk of nutritional deficiencies
kitzcorner / ShutterstockOzempic and other semaglutide medications can cause weight loss by reducing appetite and delaying gastric emptying, making you feel fuller for longer. Seniors who suddenly experience these changes may develop nutritional deficiencies in protein, vitamins, and minerals, Diana Thiara, MD, medical director of the University of California San Francisco Weight Management Program, recently told AARP.
8. Drug interactions
ShutterstockAny time you begin a new medication, it’s important to share your full list of the medications and supplements you take with your doctor. Ngo-Hamilton notes that this is especially important for people over the age of 65, who are at higher risk of drug interactions.
“Research has shown that most older adults are taking at least one prescription medication regularly,” the pharmacist notes. “Patients on other medications—regardless of age—should discuss with their healthcare provider whether Ozempic may interact with one of their other prescriptions.
She adds that it's important to understand that semaglutide, the active ingredient in Ozempic, works by slowing down gastric emptying, making you feel fuller longer. “This delayed gastric transit time can affect the absorption of oral medications, especially with drugs that require strict monitoring, such as blood thinners like warfarin or seizure medication like phenytoin,” she says.
9. Poor manual dexterity
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Ngo-Hamilton says that there’s one additional consideration for older adults, but acknowledges that it may not necessarily prevent a patient from taking Ozempic. She says it’s important for both patients and healthcare professionals to be aware of the challenges older adults may face when self-administering Ozempic or Wegovy.
“After age 50, studies have shown a decline in hand manual dexterity, which can make self-administration more difficult. Poor eyesight can also be a concern, as it's crucial to correctly prime a new pen and set the dose selector to the right dose each time,” she says.
